Clinical and necropsy findings are described in 21 patients aged 43 to 78 years (mean 63) (19 men (90%)) who had grossly visible calcified myocardial infarcts. The interval from the first clinically apparent acute myocardial infarct to death (20 patients) ranged from 2 to 26 years (mean 12). The interval was greater than 5 years in 17 patients (85%) and greater than 10 years in 11 patients (55%). At necropsy, the heart weight was increased (greater than 400 g) in all (mean 557 g), the left ventricular cavity was dilated in all, and at least 1 and usually 2 or 3 (86%) major epicardial coronary arteries were narrowed greater than 75% in cross-sectional area by atherosclerotic plaque.